This research assesses the psychosocial and hearth outcomes of those caring for children orphaned by AIDS in KwaZulu Natal (KZN), South Africa. This area is characterized by high mortality among adults of reproductive and working age, with large numbers of children orphaned by HIV/AIDS. The proposed research will build upon the applicant's qualitative pilot study (which constituted the applicant's Master's thesis) that explored the experiences among caregivers of AIDS orphans in KZN. The overarching aim of this doctoral research is to assess and characterize differences in the psychosocial wellbeing and health of those caring for AIDS orphans as a function of the context and arrangements of caregiving, comparing, for example, family versus non-family arrangements in rural versus urban environments. Based on pilot findings, the applicant will: (1) conduct a cross-sectional survey of caregivers in KZN and analyze survey data to determine the association between care arrangements and the psychosocial wellbeing and health of caregivers, using a psychometrically valid and culturally sensitive instrument (Phase I);(2) based on survey findings, conduct qualitative indepth interviews (Phase II) of the care experience in diverse communities in KZN;(3) interpret findings with attention to the South African context and use conclusions to extend existing theoretical frameworks on family structures and child care for orphans;and (4) disseminate findings to local, national, and international organizations relevant to AIDS orphan care. This multimethod approach will fill gaps in the literature by highlighting ground-level perspectives of care for children orphaned by AIDS. Effective and sustainable approaches to supporting caregivers (and children) require moving beyond largely anecdotal evidence on patterns of care and towards a deeper understanding of the epidemic's impact on those providing care. Currently, little is known about the experiences of those caring for AIDS orphans and the consequences of caregiving arrangements for orphans'health and well-being. PUBLIC HEALTH RELEVANCE: Utilizing a multidisciplinary approach, this research addresses urgent global health concerns and will continue to be of relevance to public health as the number of children orphaned by AIDS continues to grow.